Double bolus as a daily thing?

Yes. But if you are in the right situation, that is easier than fixing a high.

So in every circumstance, just think of this general question: Will it be easier to chase a high, or correct a low?

At home, fixing lows are easy. Sometimes when away from home, it’s not as easy.

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That makes sense. With the muscle disorder/eating every couple of hours anyway, it’s very easy for me to “fix” a low (I actually do think I would’ve gone low after the oatmeal this morning, but I ate some peanut butter ~2 hrs later, then was at 79 before lunch an hour after that - pb usually raises me ~20 if my BG is steady). I’ll remember to take care especially when I’m not at home.

I would not worry AT ALL about using as much insulin as you need, even if you had to go 3x or more. Don’t worry!

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i’ve read through this whole thread and have found it tremendously helpful. there was one thing, though, that wasn’t mentioned and that is the I:C ratio. i have a much different morning carb ratio than i do for the rest of the day; in fact it is quite significant ; almost double the insulin between the hours of 6 am till 10 am.

i discovered this through trial and error. it took a while, but i got there and it has been a real relief. also, in the mornings, if i am going to eat a bowl of oatmeal (or any kind of Carby food) i pre-bolus for about 1/2 hour before eating. i noticed that when i eat oatmeal for bfast i absolutely must pre-bolus and then after 2.5 hours, my BG is in target range. no spiking.

don’t know if this will help or not, but it worked for me.

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I have the same issue - my breakfast ratio is 1:25 (the rest of the day it’s 1:35). But what I’ve found with oatmeal (ok, the quick oats kind; I have to cough up the dough for some certified GF rolled oats here when I run out of these, and that will probably be easier on my BG) is I have to more than double my dose to prevent a spike. And I now pre-bolus 45 minutes for everything with Novolog. I don’t go low (unless I miss it and hit the 50-55 min mark), but it helps with minimizing the rise I get from the main staples of my diet (toast, rice, etc).

I don’t know if you have this company in the US, but Only Oats makes certified GF rolled and steel cut oats (produced in a dedicated facility that only processed oats, no other foods) and they are great and cheap! It’s only about $6 CDN for 1 kg of rolled or steel cut oats, and they also make quick oats (oat flakes) and oat flour. I buy them off Amazon.ca because they’re cheaper there than in stores. Maybe you can get them shipped to the US or find a US site that carries them.

wow. i am surprised by your I:C ratios. my lowest (morning ) one is 1:6 and then the most part of my day is 1:12.

i have tried the irish steel cut oats, and i have always had a problem with them. i think b/c they digest so slowly, i would need to do an extended bolus for them. but i LOVE using the regular Quaker Oates ( the Quick 1minute kind). i always get a predictable level BG from them.

maybe i just need a longer pre-bolus with the steel cut oats than the other ones; i will have to experiment. one of the things i prefer about the steel cut is first off, the flavor, and second, that i can make several servings and keep them in the fridge and use as needed. very convenient.

I would think that @Pianoplayer7008 has some significant endogenous insulin production, so for now her ratio’s are going to be quite large number (small amount of insulin)

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As @Chris pointed out, I’m still in early honeymoon with quite a bit of my own insulin production - suspected anyway. I’d love to get a c pep done like @Sam did recently. The last time I had a non-fasting done (BG was normal, though, not high), was over a year ago, and it was 4.5 (fasting levels are around 1).

That’s interesting. I’ve always heard steel cut/rolled are supposed to be “better” because they digest more slowly, so cause a slower, lower rise!

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i think what you are saying is 100% right. maybe i just didn’t give myself enough of a pre-bolus or perhaps my I:C ratios weren’t honed in at the time. either way, i had problems with them. i didn’t spike immediately, but i had quite a rise later at around 2 hours post meal. (this is for 1 Cup of cooked oats in the morning for breakfast.)

i think i will try my experiment with them again, because i really like them so much more. (it is a lot of work to prepare, though :wink: )

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I’d be curious to hear how it works out for you!

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i will deff keep you in mind and report back. i think i may make this on Sunday night and have it ready made in the fridge to eat on Monday morning before my swim.

i would love it if it works. its one of my favorite meals :blush:

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Ironically, I didn’t really like oatmeal at all until a couple years ago. And my favorite way to eat it was with brown sugar on a piece of toast! :laughing:

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Likely we would also have breakfast I:C giving more insulin however I already have programmed a very large basal increase in the morning. I think this is quite helpful although we still need a 45 minute pre-bolus in the morning to avoid hitting the 300’s for high GI foods like instant oatmeal, cold cereal (doesn’t matter what kind of cereal) or waffles.

If the pre-bolus is not done and the breakfast sends the BG into the 300+ range than the insulin is just not enough to get it back down. It bleeds into lunch and ends up being a problem all day.

I am a big fan of the AM basal increase and a breakfast pre-bolus.

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that actually sounds appealing to me. i doubt i could negotiate the brown sugar part of your concoction but it would be something i would try.

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wish i had discovered this years ago. it would have saved me a lot of frustrations. but at least i did figure it out ( and i did it without my old idiot endo i have mentioned so many times in the past) knowing all i do now has opened many, many new doors for me in terms of what i can and cannot eat without spiking.

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Yeah, now I just put maybe 1t coconut sugar in it (can’t do alternative sweeeners), and don’t do the toast. One day I’ll figure out how to eat it with toast again! My husband thinks it’s weird lol

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my grandmother was Russian and eat things a little diff than we do in the US. instead of putting sugar in things, she used salt. so, i grew up eating hot cereals with salt and butter. when i have tried using sweeteners (of any sort) i find it unappealing. i know that must sound crazy to you, but its now just what my taste buds expect :blush:

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The AM basal increase we have been doing since going on the pump. That actually was one of the motivations for the pump. The BG increase in the morning even without eating food was a huge deal. Being able to program the pump to deal with that was a big change for us and very helpful.

The pre-bolus was only recently (this year) that we started that. That was based on the forums and picking up new information. It is hard because we hear so many different approaches and what works for one person doesn’t work for another person but we tried this and it made a HUGE difference. I am not exaggerating when I say breakfast would sent the BG into the 300’s - it really was very difficult. But now the same amount of insulin, the same food but simply providing the insulin about 45 minutes is a total game changer. It makes the entire day better - by a lot.

One of the other HUGE tips we picked up was the basic concept that the amount of insulin to bring BG down a given number of points is just not the same in the 100’s as it is higher like in the 300’s or 400’s. With this additional information, we are much better able to treat the really high BGs.

Our Endos have really been quite impressed the last couple of appointments.

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Thats probably really helpful with diabetes, though - to already not have a huge sweet tooth with everything. I’m a little addicted to sugar… :slight_smile: